Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse (Preprint)

Eisner, Emily; Drake, Richard; Berry, Natalie; Barrowclough, Christine; Emsley, Richard; Machin, Matthew; Bucci, Sandra

doi:10.2196/preprints.11568

Cited by 3 publications

(3 citation statements)

References 77 publications

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“…Patients (n=18; convenience sample) were recruited from 3 NHS Mental Health Trusts in the North West of England to participate in a 6-month, single-arm, open longitudinal feasibility study (see study protocol for full details [53]; Research Ethics Committee reference 14/NW/1471). They were trained on ExPRESS (on their own phone, if compatible, or on a study phone) and asked to use it weekly for 6 months or until relapse, whichever was sooner.…”

Section: Methodsmentioning

confidence: 99%

Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse

Eisner¹,

Drake²,

Berry³

et al. 2019

JMIR Mhealth Uhealth

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Background Schizophrenia relapses are common, have profound, adverse consequences for patients and are costly to health services. Early signs interventions aim to use warning signs of deterioration to prevent full relapse. Such interventions show promise but could be further developed. This study addresses 2 developments: adding basic symptoms to checklists of conventional early signs and using a mobile phone app ExPRESS to aid early signs monitoring. Objective This study aimed to (1) design a pool of self-report items assessing basic symptoms (Basic Symptoms Checklist, BSC); (2) develop and beta test a mobile phone app (ExPRESS) for monitoring early signs, basic symptoms, and psychotic symptoms; and (3) evaluate the long-term acceptability of ExPRESS via qualitative feedback from participants in a 6-month feasibility study. Methods The BSC items and ExPRESS were developed and then adjusted following feedback from beta testers (n=5) with a schizophrenia diagnosis. Individuals (n=18) experiencing a relapse of schizophrenia within the past year were asked to use ExPRESS for 6 months to answer weekly questions about experiences of early signs, basic symptoms, and psychotic symptoms. At the end of follow-up, face-to-face qualitative interviews (n=16; 2 were uncontactable) explored experiences of using ExPRESS. The topic guide sought participants’ views on the following a priori themes regarding app acceptability: item content, layout, and wording; app appearance; length and frequency of assessments; worries about app use; how app use fitted with participants’ routines; and the app’s extra features. Interview transcripts were analyzed using the framework method, which allows examination of both a priori and a posteriori themes, enabling unanticipated aspects of app use experiences to be explored. Results Participants’ mean age was 38 years (range 22-57 years). Responses to a priori topics indicated that long-term use of ExPRESS was acceptable; small changes for future versions of ExPRESS were suggested. A posteriori themes gave further insight into individuals’ experiences of using ExPRESS. Some reported finding it more accessible than visits from a clinician, as assessments were more frequent, more anonymous, and did not require the individual to explain their feelings in their own words. Nevertheless, barriers to app use (eg, unfamiliarity with smartphones) were also reported. Despite ExPRESS containing no overtly therapeutic components, some participants found that answering the weekly questions prompted self-reflection, which had therapeutic value for them. Conclusions This study suggests that apps are acceptable for long-term symptom monitoring by individuals with a schizophrenia diagnosis across a wide age range. If the potential benefits are unders...

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Section: Methodsmentioning

confidence: 99%

Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse

Eisner¹,

Drake²,

Berry³

et al. 2019

JMIR Mhealth Uhealth

Self Cite

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“…This included reminding the participant of an inbuilt five-hour window to respond to questions, a feature which was included as a result of beta-testing feedback that suggested some people felt pressured by a limited response window. A heightened sense of paranoia and increased fear of recurrence were included in our protocol and medical device registration documents as anticipated risks of the intervention and heightened feelings of paranoia as a result of routine monitoring in psychosis have been reported elsewhere (Eisner et al, 2019;Terp, Jørgensen, Laursen, Mainz, & Bjørnes, 2018).…”

Section: Empower (Early Signs Monitoring To Prevent Relapse In Psychomentioning

confidence: 99%

Adverse event monitoring in mHealth for psychosis interventions provides an important opportunity for learning

Bradstreet

Allan

Gumley

2019

Journal of Mental Health

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“…Ein zentraler Punkt des ambulatorischen Assessments ist, dass das psychische Erleben und Verhalten von Personen als im Kontext situiert verstanden wird (Myin-Germeys et al, 2018, Myin-Germeys et al, 2009, Reininghaus, 2018 (Koppe et al, 2019, Maher et al, 2019, Stachl et al, 2020 (Rauschenberg et al, 2020d, Rauschenberg et al, 2017, Rauschenberg et al, 2020e, Reininghaus, 2018, Reininghaus et al, 2016b, Reininghaus et al, 2016c. (Eisner et al, 2019, van de Leemput et al, 2014.…”

Section: Introductionunclassified

Innovative digitale Versorgungsformen zur Personalisierung der stationsäquivalenten Behandlung in der alltäglichen Lebenswelt bei schweren psychischen Erkrankungen [Innovative digital forms of service delivery for personalized crisis resolution and home treatment for people with severe mental health problems]

Rauschenberg¹,

Hirjak²,

Ganslandt³

et al. 2020

Preprint

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Die stationsäquivalente psychiatrische Behandlung (StäB) wurde 2018 als neue Krankenhausleistung für Menschen eingeführt, die die Indikation für eine stationäre Behandlung erfüllen. Die rasanten Fortschritte im Bereich der Informations- und Kommunikationstechnologie bieten völlig neue Chancen für innovative digitale Versorgungsangebote wie telemedizinische, eHealth oder mHealth Verfahren. Ziel dieser Arbeit ist es einen umfassenden Überblick über neue digitale Versorgungsformen zu geben, die zur Personalisierung der StäB in der alltäglichen Lebenswelt bei schweren psychischen Erkrankungen beitragen und somit klinische und soziale Outcomes verbessern sowie direkte und indirekte Kosten reduzieren könnten. Es lassen sich vier primäre digitale Versorgungsformen identifizieren, die in diesem Sinne in der StäB gewinnbringend genutzt werden könnten: (1) Kommunikation, Behandlungskontinuität und -flexibilität durch Online-Chat und Videotelefonie; (2) Monitoring von Symptomen und Verhaltensweisen in Echtzeit durch Anwendung des ambulatorischen Assessments (Engl. Ecological Momentary Assessments (EMA)); (3) Nutzung von multimodalen EMA-Daten für die Generierung und Darbietung von personalisiertem Feedback über subjektives Erleben und Verhaltensmuster sowie (4) auf Person, Moment und Kontext zugeschnittene, adaptive ambulatorische Interventionen (Engl. Ecological Momentary Interventions (EMIs)). Neue digitale Versorgungsformen haben erhebliches Potential die Effektivität und Kosteneffektivität der aufsuchenden fachpsychiatrischen und psychotherapeutischen Behandlung zu steigern. Ein wichtiger nächster Schritt besteht nun darin, die Anwendung dieser Versorgungsformen im Bereich der StäB zu modellieren und deren Qualität aus Patientensicht, Sicherheit, und initiale Prozess- und Ergebnisqualität sowie Implementierungsbedingungen sorgfältig zu untersuchen. Abstract:Ward-equivalent treatment (StäB), a form of crisis resolution and home treatment in Germany, has been introduced in 2018 as a new model of mental health service delivery for people with an indication for inpatient care. The rapid progress in the field of information and communication technology offers entirely new opportunities for innovative digital mental health care such as telemedicine, eHealth, or mHealth interventions. This paper aims to provide a comprehensive overview of novel digital forms of service delivery in the daily lives of help-seeking individuals for personalized delivery of StäB that may contribute to improving clinical and social outcomes as well as reducing direct and indirect costs. Four primary digital forms of service delivery have been identified that can be used for personalized delivery of StäB: (1) communication, continuity of care, and flexibility through online chat and video call; (2) monitoring of symptoms and behaviour in real-time through ecological momentary assessment (EMA); (3) use of multimodal EMA data to generate and offer personalized feedback on subjective experience and behavioural patterns as well as (4) adaptive ecological momentary interventions (EMIs) tailored to the person, moment, and context in daily life. New digital forms of service delivery have considerable potential to increase the effectiveness and cost-effectiveness of crisis resolution, home treatment, and assertive outreach. An important next step is to model and initially evaluate these novel digital forms of service delivery in the context of StäB and carefully investigate their quality from the user perspective, safety, feasibility, initial process and outcome quality as well as barriers and facilitators of implementation.

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Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse (Preprint)

Cited by 3 publications

References 77 publications

Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse

Development and Long-Term Acceptability of ExPRESS, a Mobile Phone App to Monitor Basic Symptoms and Early Signs of Psychosis Relapse

Adverse event monitoring in mHealth for psychosis interventions provides an important opportunity for learning

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